Implementation of a multimodal infection control program during an Acinetobacter outbreak.
OBJECTIVE
Acinetobacter in the ICU presents a challenge worldwide due to its capacity for long-term survival on environmental surfaces. This report describes a multimodal infection control program designed to control a sustained outbreak Acinetobacter colonization.


METHODS
Multimodal interventions implemented by unit-appointed infection control nurses in an Australian intensive care unit (ICU) during a sustained outbreak of Acinetobacter colonization.


RESULTS
In the first 12 months of the outbreak, the mean monthly colonization rate was 3.1 (+/-1.2) cases per 100 bed-days (increased from 0.5 [+/-0.4] in the previous 6 months). In the subsequent 20-months, the mean monthly colonization rates declined to 1.5 (+/-1.5) cases per 100 bed-days (P=0.004). Hand hygiene compliance increased from 33% (95% CI 30-36%) before action plan implementation to 49% (95% CI 46-52%) measured 6-months after implementation. Compliance subsequently dropped to 39% (95% CI 36-42%) 12-months after implementation. The median volume of alcohol/chlorhexidine hand rub solution used per 1000 bed-days increased from 24L (interquartile range (IQR) 12-47L) to 148L (IQR 120-165L) per 1000 bed-days (P<0.001).


CONCLUSIONS
Introduction of ICU-appointed infection control nurses, who then led multimodal interventions, was effective in reducing the rate of Acinetobacter colonization.
Rose
Louise
L
Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Canada. louise.rose@utoronto.ca
Rogel
Kelly
K
Redl
Leanne
L
Cade
John F
JF
D000151:Acinetobacter Infections / Q000453:epidemiology / Q000517:prevention & control* / Q000635:transmission; D000328:Adult; D000368:Aged; D001315:Australia / Q000453:epidemiology; D003428:Cross Infection / Q000453:epidemiology / Q000517:prevention & control* / Q000635:transmission; D004196:Disease Outbreaks / Q000517:prevention & control*; D005260:Female; D006801:Humans; D017053:Infection Control / Q000458:organization & administration*; D016357:Infection Control Practitioners / Q000458:organization & administration*; D007362:Intensive Care Units / Q000458:organization & administration; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D024802:Nurse's Role; D009731:Nursing Audit; D015403:Nursing Evaluation Research; D016730:Program Development; D015397:Program Evaluation; D012189:Retrospective Studies